Illuminated surgical access system including a surgical access device and coupled light emitter

ABSTRACT

A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a port and a light emitter coupled to the surgical access device for illuminating the port. The light emitter preferably comprises an elongated shaft having a light transmitting element housed therein, which emits light transmitted to the elongated shaft from a light source. The elongated shaft is configured to be inserted in an elongated channel in the access device. The elongated channel has or forms a window for transmitting light emitted by the light emitter into the interior of the access device.

FIELD OF THE INVENTION

The present invention relates to devices used in surgery. Moreparticularly, the present invention relates to instrumentation and amethod for the providing access and illumination for surgical sites,implements and implants.

BACKGROUND OF THE INVENTION

In invasive surgical procedures, illumination of a working space may berequired to facilitate use of the surgical instruments. For example, inspinal surgery, access ports, comprising generally tubular, open-endedstructures, are often used to provide access to a surgical site. Theaccess ports may require illumination at the distal end thereof tofacilitate the surgical procedure.

Achieving proper illumination of a surgical site during minimallyinvasive surgery can be difficult. In the current state of the art,external light sources are used to provide illumination to access ports.However, external light sources are unwieldy, and the link used totransmit the generated light to the access port can be cumbersome andblock access by a surgeon to the port. For example, a surgeon may wear ahead-mounted light in order to illuminate the working area at the baseof an access port. Head-mounted light sources may require the surgeon toconstantly direct the light with his or her head at an optimal angle,into the access port in order to view the working area. In addition,fiber optic cables, attached to the light, can encumber the surgeon andtether him or her to a light source.

Another option currently used by surgeons involves lights mounted on anoverhead microscope. When surgeons use an overhead microscope toilluminate a surgical space, the light source is distant from thesurgical site, increasing the likelihood of creating shadows andpotentially obstructing the ability of the light to reach the workingarea.

Other alternatives for lighting a surgical site place small lightsources into the interior of an access port to illuminate the workspace. However, the use of a light source within the access port canreduce the available working area in the port, and may hinder the use ofinstruments that enter and exit the port during surgery.

SUMMARY OF THE INVENTION

The present invention provides an illuminated surgical access systemincluding a light emitter coupled to a surgical access device. Thesurgical access device defines a path or port to a surgical site and thelight emitter emits and directs light into and along the path toilluminate a surgical site accessed by the surgical access device. Thelight emitter may have an elongated shaft having light transmitters,such as fiber optic cables connected to a light source, that terminatealong the elongated shaft to emit light from the shaft. The elongatedshaft is configured to be inserted in an elongated channel on thesurgical access device. The elongated channel has a window or otheropening to the interior of the surgical access device, so that lightemitted from the light-emitting shaft passes to the interior of thesurgical access device and is directed to a working area at a distal tipof the surgical access device closest to the body. The integrated lightemitter does not reduce the working area of the access device or hinderthe surgeon, while providing superior illumination of a surgical site.

According to a first aspect of the invention, an illuminated surgicalaccess system for providing access to a patient during surgery isprovided. The illuminated surgical access system comprises a surgicalaccess device comprising at least one sidewall, defining an interiorpath forming a port for accessing the patient and an elongated channelformed on the side wall and an elongated light-emitting shaft insertedin the elongated channel. The elongated light-emitting shaft includes alight transmitting element for emitting light to illuminate the port ofthe access device.

According to another aspect of the invention, a light emitter for asurgical access system is provided. The light emitter comprises anannular base, a plurality of protruding shafts extending from the base,the plurality of protruding shafts distributed about the perimeter ofthe annular base and a plurality of fiber optic cables extending from alight source to the annular base. A subset of the fiber optic cablesbranch from the annular base through each protruding shaft and terminateat an outlet of the respective protruding shaft so as to emit lighttherefrom.

According to another aspect of the invention, a light emitter for asurgical access system comprises a housing in the shape of an elongatedshaft, a branched path extending through the housing, the branched pathhaving an inlet and a plurality of outlets and a bundle of fiber opticcables passing through the branched path. The bundle of fiber opticcables branches off into branches, with a subset of the fiber opticcables passing through a branch of the path and terminating at theoutlet to emit light transmitted through the subset of the fiber opticcables.

According to still another aspect of the invention, a tubular surgicalaccess device for accessing a surgical site is provided. The tubularsurgical access device includes a tubular body having a side wall anddefining a path therethrough forming a port for accessing the patient,an elongated channel formed on the side wall of the tubular body and awindow formed in the elongated channel for interfacing the elongatedchannel with the path through the tubular body.

According to another aspect, a method of accessing a surgical site in apatient comprises the steps of providing a surgical access devicecomprising at least one sidewall having an elongated channel anddefining a path therethrough forming a port for accessing the patientand inserting an elongated light-emitting shaft into the elongatedchannel.

BRIEF DESCRIPTION OF THE FIGURES

These and other features and advantages of the present invention will bemore fully understood by reference to the following detailed descriptionin conjunction with the attached drawings in which like referencenumerals refer to like elements through the different views. Thedrawings illustrate principals of the invention and, although not toscale, show relative dimensions.

FIG. 1 illustrates an illuminated surgical access system including alight emitter comprising a light-emitting shaft according to anembodiment of the invention.

FIGS. 2A and 2B illustrates an embodiment of a light-emitting shaft fora surgical access system according to an illustrative embodiment of theinvention.

FIG. 3 illustrates another embodiment of a light-emitting shaft for asurgical access system according to an illustrative embodiment of theinvention.

FIG. 4 illustrates a surgical access device suitable for use with thelight-emitting shaft of FIGS. 2A and 2B and/or the light emitting-shaftof FIG. 3.

FIGS. 5A and 5B illustrates another embodiment of a light-emitting shaftincluding a single light emission point suitable for use in anilluminated surgical access system of the invention.

FIGS. 6A and 6B illustrate embodiments of surgical access devicessuitable for use with the light-emitting shaft of FIGS. 5A and 5B.

FIG. 7A-7C illustrate another embodiment of an illuminated surgicalaccess system of the invention.

FIG. 8 illustrates an elongated light emitter suitable for use in thesystem of FIGS. 7A-7C.

FIG. 9 illustrates a cover suitable for use with the illuminatedsurgical access system of FIGS. 7A-7C.

FIG. 10 illustrates an embodiment of a light-emitting shaft includingtabs for securing the light-emitting shaft to a surgical access device.

FIGS. 11A and 11B illustrate another embodiment of an elongated lightemitter comprising a plurality of light-emitting protrusions extendingfrom a base and a corresponding surgical access device according toanother embodiment of the invention.

FIGS. 12A and 12B illustrate an embodiment of an elongated light emitterhaving a helical configuration and a corresponding surgical accessdevice.

FIGS. 13A and 13B illustrate another embodiment of an elongated lightemitter having a helical configuration and a corresponding surgicalaccess device.

FIGS. 14A-14D illustrate an embodiment of an elongated light emitterhaving an annular configuration and a corresponding surgical accessdevice.

FIGS. 15A-15B illustrate an elongated light emitter and correspondingsurgical access device where the light emitter forms a portion of theside wall of the surgical access device according to another embodimentof the invention.

FIGS. 16A-16D illustrate an annular elongated light emitter configuredto be received in an interior channel of a surgical access deviceaccording to another embodiment of the invention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides an improved surgical access system foraccessing a surgical site during surgery including an integrated lightemitter for illuminating the surgical site and/or a path to the surgicalsite. The present invention will be described below relative to certainillustrative embodiments. Those skilled in the art will appreciate thatthe present invention may be implemented in a number of differentapplications and embodiments and is not specifically limited in itsapplication to the particular embodiments depicted herein.

The illuminated surgical access system of the illustrative embodiment ofthe invention may be used in spinal surgery, for example, during adiscectomy or microdiscectomy procedure to remove damaged disc materialfrom the spine, though one skilled in the art will recognize that theinvention can be used with any surgical instrument in any surgicalprocedure that requires illumination. Examples of surgical proceduressuitable for employing the illuminated surgical access system of thepresent invention include, but are not limited to, insertion ofinterbody fusion devices, bone anchors, fixation devices, includingrods, plates and cables, artificial disks, hip stems, artificalligaments, trochars for gastro-intestinal work, or any procedurerequiring access to a patient as well as visualization. The surgicalaccess system may be part of any suitable implant instrument used toprovide access to a particular area of a patient's body wherevisualization is also needed. The surgical access system can be used toposition any suitable implant, instrument and/or other device in anysuitable procedure where guidance of the implant, instrument and/ordevice is used. Alternatively, or in addition to providing guidance, thesurgical access system may be used to dilate a surgical incision using aset of progressively larger cannulas or an expanding cannula to provideaccess to a surgical site.

Referring to FIG. 1, an illuminated surgical access system 1 of anillustrative embodiment of the invention includes a surgical accessdevice 10 for accessing a surgical site and a light emitter 50 coupledto the access device 10 for providing illumination to the surgical siteduring performance of a surgical procedure. In the illustrativeembodiment, the light emitter 50 comprises an elongated shaft that emitslight and is coupled to the access device 10. Preferably, the lightemitter 50 is held in a channel, which may be an opening, slot, lumen,groove, or other suitable channel, formed in the body of the accessdevice 10, as described in detail below. An intermediate lighttransmitter, illustrated as a light transmitting cable 60, transmitslight from a light source 70 to the light emitter 50, which emits thelight 71 into the path of the access device 10.

The illustrative access device 10 may be a standard access port, in theshape of a cannula comprising a hollow tubular body suitable forinsertion in and/or placement adjacent to a patient's body. Theillustrative access device 10 has at least one hollow central channel orlumen defining a path 42 extending from an open proximal end 41 of theaccess device to an open distal end 43 of the access device. The path 42may form a working channel or at least a portion of a working channelfor accessing a surgical site adjacent to or in the vicinity of thedistal end 43 of the tubular body. In the illustrative embodiment, thebody of the access device 10 includes open proximal end 41 that forms aproximal port 45, and the open distal end 43 forms a distal port 47 forallowing access to the surgical site. One skilled in the art willrecognize that the access device 10 may have any suitable configurationand size for providing access to an area of a body. The illustrativeaccess device may be used for retaining soft tissue away from a surgicalsite and/or guiding a surgical instrument, device and/or implant, thoughone skilled in the art will recognize that the access device maycomprise any suitable device defining a path or channel requiringillumination.

As shown, the tubular body of the illustrative access device 10 isformed by a cylindrical sidewall 40, though one skilled in the art willrecognize that the tubular body can have any size, shape, configurationand number of sidewalls. The access device can be any suitable devicedefining a port for providing access to a surgical site. The accessdevice can have any suitable cross-section and is not limited to thecylindrical cross-section shown in the illustrative embodiments. Theaccess device can be open or closed to define an open or closed path 42therethrough.

The access device can be formed of any suitable surgical material, suchas, but not limited to, plastic, surgical stainless steel and othermaterials known in the art.

The tubular body includes at least one elongated channel 48 formed on orin the side wall 40 for receiving the elongated light emitter 50. Thelight emitter 50 couples to the tubular body 40 to transfer and emitlight 71 produced by a light source 70 to illuminate the path 42 and/orthe distal port 47 at the distal end 43 of the access device 10.

Preferably, the light emitter 50 is inserted in the elongated channel 48in the housing of the access device 10 to couple the light emitter 50 tothe housing. The channel 48 preferably has a shape that matches theshape of the light emitter 50. The channel 48 includes at least onewindow 49, comprising a transparent portion interfacing the channel 48with the interior path 42 of the access device, to allow transmission oflight from the light emitter 50 to the interior of the access device, asdescribed in detail below. The window 49 may comprise an opening in theside wall 40 of the access device 10 adjacent the outlet of the lightemitter 50, or may be formed of transparent material adjacent theoutlet. Any suitable translucent means, including air, may form thewindow 49.

The window may cover the entire length of the channel 48, or onlyselected portions of the channel 48.

Preferably, the light emitter 50 may be removably coupled to the accessdevice 10, so that the light emitter 50 may be easily used with avariety of different access devices and/or removed to facilitatecleaning.

Preferably, the light emitter 50 comprises a housing 51, which may be inthe shape of an elongated shaft, and at least one light transmissionelement 52 disposed in the housing for emitting light. In theillustrative embodiment, the light transmission element 52 comprises aplurality of fiber optic strands extending from the light source 70through the intermediate light transmitter 60 to the housing 51 totransmit light generated by the light source 70 to the housing 51. Asdescribed below, the housing 51 preferably includes an inlet forreceiving the light transmission element or an intermediate lighttransmitter that delivers light to the light transmission element, andat least one outlet for emitting light from the light transmissionelement 52.

The housing 51 may be formed of any suitable surgical material, such as,but not limited to, plastic, epoxy, surgical stainless steel, titanium,ceramics, and other materials known in the art.

The light transmission element 52 may comprise glass fiber optic cables,plastic fiber optic cables or any other suitable means for transmittingand emitting light.

As shown, the intermediate light transmitter 60 is a cable that bundlesthe transmission elements 52 in the region between the light source 70and the light emitter housing 51. Alternatively, a separate transmissionmeans may be used to transmit light from the light source 70 to thelight transmission element 52 in the housing 51.

The light source 70 may be any suitable device for producing light,including, but not limited to, halogen light boxes, incandescent lightboxes and other light sources readily available in most hospitalsettings, such as those available from Welch Allyn Medical Products ofSkaneateles Falls, N.Y. The light source may have any suitable powerlevel. In an illustrative embodiment, the light source is a 300 WattHalogen Light Box. Any other suitable light source capable of producinglight that is transmitted via the light transmitters, such as fiberoptic cables, may also be used.

FIGS. 2A and 2B illustrate one embodiment of an elongated light emittersuitable for use in an illuminated access system according to anillustrative embodiment of the invention. The light emitter 150 of FIGS.2A and 2B comprises an elongated shaft 151 defining a branched path 154therethrough, shown in FIG. 2B, for housing a bundle of fiber opticstrands 152. The branched path 154 terminates in a plurality of outlets155 a-155 e spaced along the length of the elongated shaft 151. Thebundle of fiber optic strands 152 enters the elongated shaft 151 at aninlet 153 as a sheathed fiber optic cable 60, which is preferablyconnected to a light source that produces light, which is thentransmitted through the fiber optic cable and through the fiber opticstrands 152. Inside the casing, the fiber optic strands branch out intobranches 160 a-160 e through branched paths 154 a-154 e and terminate atthe outlets 155 a-155 e, respectively, where the light is emitted fromthe end each strand. The ends of the strands may be cut at a selectedangle to direct light transmitted therethrough to a selected locationand in a selected direction. In this manner, light is emitted along thelength of the housing 151. Each branch 160 a-160 e of fiber opticstrands may comprise one or several fiber optic strands.

Preferably, the outlets 155 a-155 e where light is emitted are equallyspaced along the length of the shaft 151 to prevent shadows.

Alternatively, each fiber optic strand 152 may include a modifiedcladding or other suitable means at selected locations to provide lightemission points along the length of the fiber optic strand. Eachemission point preferably aligns with an outlet 155 and/or transparentportion of the housing of the light emitter 150 to allow light emissionfrom the light emitter.

The ends of the fiber optic strands 152 may be polished and set in placewithin the outlets 155 a-155 e via any suitable means. For example, anepoxy may be used to seal and/or fix the fiber optic strands within therespective branch path 154.

In one embodiment, the housing 151 of the elongated light-emitting shaft150 may comprise a transparent, semi-rigid, light-transferring mediumthat encases the fiber optic strands and/or the termination points ofthe fiber optic strands 152. When light is emitted from the end of astrand, the encased medium then reflects or scatters exiting light fromeach individual strand out of the shaft 150, creating a diffuse lightsource. For example, fiber optic strands may be coated in a suitablemedium, such as an epoxy, which is then shaped to form the elongatedlight-emitting shaft 150 with branched paths 154.

In another embodiment, the housing 151 may be molded to define thebranched path 154.

FIG. 3 illustrates another embodiment of a light-emitting shaft 150′including a plurality fiber optic strands terminating along a linearpath according to another aspect of the invention. In the embodiment ofFIG. 3, the shaft housing 151′ comprises a transparent medium thatencases a plurality of fiber optic strands 152′. The fiber optic strands152′ terminate at different heights along the length of the transparenthousing 151′. Each fiber optic strand emits light from an emission point155 a′, 155 b′, 155 c′, 155 d′ and 155 e, which is illustrated as thetermination point of the strand. The light is transmitted through thetransparent medium, so that emit light is emitted along the length ofthe shaft 150′.

A corresponding surgical access device 110, shown in FIG. 4, includes atleast one elongated channel, illustrated as a slot or a groove 148, forreceiving the light emitter 150 to couple the light emitter 150 or 150′thereto. In the embodiment of FIG. 4, the elongated groove 148 comprisesan open channel formed in the outer surface of the side wall 240defining the access device 110. The illustrative groove 248 extendssubstantially parallel to the longitudinal axis of the access deviceinternal working area. The groove 148 has an open proximal end extendingto the top proximal end of the access device 110 to allow the lightemitter 150 or 150′ to slide into the groove, as shown in FIG. 4.

Alternatively, the elongated groove 148 may be a closed channel formedwithin the side wall, a channel formed in an interior surface of theside wall, or may comprise an elongated opening in the side wall, asdescribed in certain additional embodiments below. The elongated channel148 in the access device may have any suitable size, configuration andlocation suitable for receiving a light emitter, such as the lightemitter 150 or 150′.

The access device 110 of FIG. 4 has a plurality of grooves 148 dispersedabout the perimeter of the access device, with each groove 148configured to receive a light-emitting shaft, such as the light emitter150 or 150′. The access device may include any suitable number ofgrooves configured to receive light emitters.

As shown, each groove 148 includes at least one window 149 to the path142 for transmitting light emitted from the light emitter 150 or 150′ tothe path 142. In the illustrative embodiment, each groove 148 includes aplurality of windows 149 at different heights along the length of thegroove. Each window 149 preferably aligns with an outlet 155 or otherlight emission point of the light emitter 150 or 150′ when the lightemitter is inserted in the groove 148, so that light emitted from theoutlets 155, 155′ or other light emission point is transferred into theinterior of the access device 110.

As shown, the illustrative light emitters 150 and 150′ of FIGS. 2A-3have a substantially wedge-shaped cross section to facilitate insertionof the light emitter in the corresponding groove 148 of the accessdevice, while preventing the light emitter from falling out of thegroove. The illustrative corresponding groove 148 in the access device110 has a matching wedge shape to allow the light emitter 150 or 150′ toslide therethrough to couple the light emitter to the access device.Alternatively, the light emitter 150 or 150′ and corresponding groove148 may have a circular, oval or other suitably shaped cross-section.

The angle of the wedge of the light emitter housing 151 or 151′ be madeto create a dovetail joint with the corresponding groove 148 runningdown the outer wall of the access device 10 to provide a track for thelight emitter 150 or 150′ to move along while maintaining a setalignment with the port 110.

When the light emitter 150 or 150′ is coupled to the access device 110and exposed to a light source, the terminating points of the fiber opticstrands, or other light transmission elements employed by the lightemitter, shine directional light through the windows 149 in the walls ofthe access device, illuminating the work area of the access device 110,without interfering with the working space.

FIGS. 5A and 5B illustrate another embodiment of an elongated lightemitter 250 suitable for use in an illuminated surgical access systemaccording to an illustrative embodiment of the invention. The lightemitter 250 comprises an elongated shaft 251 forming a housing. Thehousing defines a single path 254 that turns and terminates at an outlet253 for housing a light transmission element, such as a fiber opticcable 252 comprising one or more fiber optic strands. The outlet 253 ispreferably located at a lower end of the shaft 251.

As described above, the outlet may include epoxy or another means forfixing the fiber optic cable 252. The housing may be a transparentmedium and the outlet 253 may be open or comprise a transparent mediumcovering the end of the fiber optic cable.

A corresponding access device 210, shown in FIG. 6A, has one or moregrooves 248 formed in the side wall 240 for receiving the elongatedlight emitter 250 to couple elongated light emitter to the access device210. The illustrative grooves 248 each include at least one elongatedwindow 249 interfacing the corresponding groove with the device interiorpath 242. The elongated window 249 allows adjustment of height of thelight emitter 250 along the path length, while maintaining the lightemitting outlet 253 of the light emitter 250 in alignment with at leasta portion of the window 249, so that a user can adjust the direction ofthe emitted light according to his preference.

FIG. 6B is another embodiment of an access device 210′ including anelongated window 249′ in a groove 248′ for receiving a light emittingshaft, such as the light emitting shaft 250 of FIGS. 5A and 5B. Theaccess device 210′ of FIG. 6B includes a rigid arm attachment 202 forattaching the access device 210′ to a base or other suitable system forallowing positioning of the illuminated surgical access system relativeto a selected surgical site.

According to another embodiment of the invention, shown in FIGS. 7A-9,an elongated light emitter comprising a light emitting shaft 350 may beinserted into a longitudinally extending a closed channel, illustratedas lumen 348 extending longitudinally through the side wall 340 of theaccess device 310, substantially parallel to the longitudinal axis path342 of the access device. The access device 310 can have a plurality oflongitudinally extending lumens 348 distributed about the periphery ofthe device for receiving a plurality of elongated rod-likelight-emitters, such as the light emitter 350 shown in FIG. 8. Eachlongitudinally extending lumen 348 includes at least one window 349configured to align with an emission point on the light emitter 350 totransfer light from the light emitter to a selected location. The window349 preferably forms an interface to the access device interior 342.

Alternatively, or in addition, one or more windows 349′ can be disposedat the distal end 370 of the side wall 340 to direct lightlongitudinally through the side wall 340 to the distal tip of the accessdevice and to the surgical site.

A cover 360 may also be provided for closing the lumens 348 andretaining the elongated light emitters within the lumens. Theillustrative cover 360 is ring-shaped, including an annular opening 361and an annular body 362 that fits over the side wall of the accessdevice. The cover 360 may also include protrusions 364 extending fromthe body 362 that are configured to be received in the top portion ofeach lumen 348 to close the lumens 348.

As shown in FIG. 7C, a plurality of elongated light emitters 350 may beconnected to a single cable 60, which branches off to form each lightemitter 350. The branching portion 601 of the cable 60 may be seated ina recess 367 formed about the top surface of the access device 350.Alternatively, the branching portion may wrap around an outer surface ofthe side wall 340, or rest on the top surface of the side wall 340.

Alternatively, each light emitter 350 inserted in a lumen 348 may beseparate and individually connected to a dedicated cable and/or lightsource, as shown in FIG. 7A.

In the embodiments of FIGS. 7A-8, the elongated light emitter 350 andcorresponding lumen 348 on the surgical access device 350 havesubstantially circular cross-sections, though, as described above, thecross-sections may have any suitable size and shape. In addition, theelongated light emitter 350 may have any suitable housing and lighttransmission element for emitting light from the elongated lightemitter.

The illuminated surgical access system of the present invention mayinclude a retention means for holding the elongated light emitterrelative to a corresponding surgical access device. The retention meansmay also allow for adjustment of the position of the light emitterrelative to the access device to control the direction and location ofthe emitted light.

For example, as shown in FIG. 10, the elongated light emitter-receivingchannel and/or the elongated light emitter may include a ratchetingmeans for adjustably retaining the elongated light emitter in thechannel. In the embodiment of FIG. 10, the elongated light emitter 450includes spring loaded teeth 321 including protrusions 322 that engagecorresponding notches in the elongated channel of the correspondingaccess device. The spring force of the teeth 321 keep the protrusionsengaged in the channel and maintain the position of the light emitter450 within the channel. A user can adjust the height of the lightemitter within the channel by depressing the tabs to disengage the teethfrom the notches, and then slide the light emitter 450 to a selectedlocation in the channel.

One skilled in the art will recognize that any suitable means forreleasably coupling an elongated light emitter to an access device maybe used.

According to another embodiment of the invention, a light emitter cancomprise a plurality of light-emitting shafts extending from a base. Forexample, as shown in FIGS. 11A and 11B, a light emitter 550 can comprisea housing 551 forming a ring-shaped base 561 and a plurality ofprotruding shafts 571 extending from the base 561. Each protruding shaft571 is sized, spaced and configured to be received in a groove 548 on acorresponding access device 510 when the ring 561 is slipped over theproximal end of the access device, as shown in FIG. 1B. Each protrudingshafts includes a light transmission element, such as a bundle of fiberoptic strands, extending therethrough that may emit light 71.

The ring-shaped base 561 may be seated in a recess formed on the topproximal surface of the side wall 540, or may be seated flat against thetop proximal surface. Alternatively, the ring may engage an outersurface of the side wall 540.

In the embodiment with of 11B, the light emitter 550 includes an armattachment 502 for attaching the illuminated access system to a base orsuitable system for allowing positioning of the illuminated surgicalaccess system relative to a selected surgical site.

The protruding light-emitting shafts 571 may have any suitableconfiguration. For example, each protruding, light-emitting shaft 571can be shaped like the light emitter 150 of FIGS. 2A and 2B or 3, withlight emission along length of shaft, the light emitter 250 shown FIGS.5A and 5B, with a single termination point, the rod-like configurationconfigured to be inserted through a side wall, as shown in FIGS. 7A-7B,or another configuration.

According to another embodiment of the invention, the elongated housingof a light emitter can be flexible and/or have a non-linear shape. Forexample, as shown in FIGS. 12A-12B, an elongated light emitter 650 canhave a housing that is helical in shape. A corresponding access device610 includes a helical channel 648 configured to receive the helicallight emitter 650. The illustrative helical channel 648 is a grooveformed on the exterior access device side wall 640. However, the helicalchannel 648 can alternatively be formed within the side wall 640, suchthat the light emitter is threaded into the channel. The channel 548includes windows for transmitting light from a light emitter 650received in the channel to the interior 642 of the access device 610.

The elongated helical light emitter 650 may have a plurality of lighttransmission elements, such as fiber optic cables, embedded therein foremitting light into the interior 642 of the access device 610. The fiberoptic cables may have various termination points to emit light atdifferent locations along the length of the light emitter 650, or mayhave a single termination point. Preferably, the termination pointswhere light is emitted are equally spaced to prevent shadows.

The helical channel 648 can be formed in any suitable location on theaccess device. For example, as shown in FIGS. 13A and 13B, the helicalchannel 648′ can be disposed only on a distal end of the access device610′ for receiving a similarly-shaped light emitter 650′ to emit lightat the distal end, closer to the surgical site.

FIGS. 14A-14D illustrate still another embodiment of an elongated lightemitter configured to be coupled to an access device. The light emitter750 has a ring shape including one or more light transmission elements752 matching an annular channel 748 formed at a lower end of thecorresponding access device 710. The access device 710 can also includea longitudinal channel 762 extending through the side wall 740 of theaccess device 710 for passing cable, or another suitable lighttransmitter, to the ring-shaped channel 748. One or more windows 749 areprovided in the annular channel 748 for passing light from a lightemitter 750 inserted in the groove to the interior path 742 of theaccess device. Preferably, each light transmission element 752 alignswith a window 749 when the light transmitter 750 is inserted in thechannel 748.

According to still another embodiment of the invention, shown inn FIGS.15A-15B, the housing 851 of an elongated light emitter 850 can form aportion of the side wall 840 of the access device 810. For example, theaccess device 810 may comprise an annular base 812, with a substantiallytubular side wall 840 that is not fully closed and includes a channelformed by gap 814 between edges 840 a and 840 b of the side wall 840.The light emitter 850 may be shaped to fit into the gap 814 to completethe side wall and remain in place during the subsequent surgicalprocedure. In this embodiment, the window for transmitting light from alight emitter to the interior 842 and the elongated channel forreceiving the light emitter comprise the same element and light emittedfrom the light emitter 850 is immediately directed into the accessdevice interior 842. As shown, the annular base 812 of the access device810 may include a recess 816 or other suitable means for retaining thelight emitter. The light emitter 850 may releasably engage the edges 840a, 840 b of the side wall 840 through any suitable means.

In the embodiment of FIG. 15B, the light emitter 850 includes an armattachment 802 for attaching the illuminated access system to a base orsuitable system for allowing positioning of the illuminated surgicalaccess system relative to a selected surgical site.

One skilled in the art will recognize that the access device 810 mayinclude a plurality of openings for receiving a plurality of lightemitters 850 that complete the side wall 840 and provide illumination ofthe device interior.

In still another embodiment, a light emitter can comprise a lightemitting ring that fits into a recess in the inner surface of the accessdevice, as shown in FIGS. 16A-16D. The illustrative light emitter 950comprises an annular housing 951 including an annular groove 959 formedon a bottom surface for receiving a bundle of fiber optic cables orother suitable light transmission element. The termination points of thefiber optic cables are preferably distributed about the groove 959 todistribute light transmitted through the fiber optic cables radially.The housing 951 may also include an exit hole 962 for connecting thefiber optic cables to a light source, which provides light that istransmitted through and emitted by the fiber optic cables.

As shown in FIG. 16D, the annular light emitter is preferably coupled toan interior channel 948 of a corresponding access device 910. Theillustrative channel 948 may be formed by a plurality of interior slotsconfigured to receive protrusions 958 extending from the annular base ofthe light emitter 950. The protrusions 958 are sized and dimensioned tobe received in the slots to couple the annular light emitter 950 to theaccess device 910. Alternatively, the interior channel 948 may comprisea shelf formed about the inner diameter of the access device 910. Inthis manner, the light emitter provides light radially about theinterior path 942 of the access device 910.

As described above, the access device 10 forming the illuminatedsurgical access system provides working channel from the skin proximatevertebrae to perform a procedure at or near the vertebrae. An example ofa suitable access device is the PIPELINE® discectomy port available fromDePuy Spine, Inc of Raynham, Mass., though any suitable access devicemay be used.

The access device 10 forming the illuminated surgical access system canbe spaced from or directly interface with a surgical site. The distalend 47 of the tubular body can be configured to interface with bone oranother feature to facilitate positioning of the tubular body along asuitable trajectory relative to the surgical site. For example, thedistal end 47 may shaped to engage a part of the surgical site, such asa vertebral structure, and can optionally include teeth or othersuitable feature formed on an outer surface for engaging a part of thesurgical site, such as a vertebra.

The tubular body 40 of the illustrative access device 10 can be rigid,semi-rigid or flexible, and can have any suitable size, shape andconfiguration suitable for defining a working channel and/or access to asurgical site. In the illustrative embodiment, the tubular body isstraight to define a straight channel therethrough, though one skilledin the art will recognize that the tubular body may define a shapedtrajectory therethrough. The tubular body is not limited to a tubularstructure having closed sidewalls and can be any component that definesa path, including an open channel or a solid member.

The path through the access device may also or alternatively form aworking channel configured to receive selected surgical instruments,such as awls, bone taps, obturators, drills, guide wires, and/orimplants, such as screws, fusion devices, artificial disks and hipstems, along the longitudinal axis thereof.

In one embodiment, the illuminated access device 10 may be configured toguide instruments along the working channel. In such an embodiment, theinner diameter of the tubular body may be slightly larger than the outerdiameter of the instrument guided by the tubular body, so that theinstrument can be inserted through the tubular body while the sidewallsof the tubular body maintain the instrument at a predetermined anglerelative to the patient. Alternatively, an instrument to be guided bythe tubular body can be configured to slide over the tubular body, withthe tubular body maintaining the orientation of the instrument as theinstrument slides relative to the tubular body. In this embodiment, thetubular body can have an outer diameter that is slightly less than aninner diameter of an instrument. However, the access device 10 need notform a trajectory or guide for instruments and can be any devicesuitable for providing access to a surgical site.

The use of an elongated light emitter configured to be coupled to asurgical access device via a channel formed on the surgical accessdevice provides significant advantages over prior systems for providingillumination during a surgical procedure. The elongated light emittereasily integrates illumination into a surgical access device, withoutrequiring cumbersome cables, while allowing direction of light to anideal location. The elongated light emitter may be moved or adjusted toadjust the location and direction of the emitted light relative to thesurgical site and or working channel. The elongated light emitter doesnot compromise or reduce the working area, as it is coupled to a channelin the side wall of the surgical access device, and provides superiorillumination. In addition, the elongated light emitter may be easilyremoved or decoupled from a surgical access device to allow reuse,disposal or cleaning. In this manner, the elongated light emitter of theillustrative embodiments of the invention provides enhanced illuminationduring many types of surgical procedures.

The present invention has been described relative to an illustrativeembodiment. Since certain changes may be made in the above constructionswithout departing from the scope of the invention, it is intended thatall matter contained in the above description or shown in theaccompanying drawings be interpreted as illustrative and not in alimiting sense.

It is also to be understood that the following claims are to cover allgeneric and specific features of the invention described herein, and allstatements of the scope of the invention which, as a matter of language,might be said to fall therebetween.

1. An illuminated surgical access system for providing access to apatient during surgery, comprising: a surgical access device comprisingat least one sidewall, defining an interior path forming a port foraccessing the patient and an elongated channel formed in the side wallon an exterior surface of the surgical access device, the elongatedchannel extending from a proximal end of the elongated channel to adistal end of the elongated channel; and a straight elongatedlight-emitting shaft slidably inserted in the elongated channel along alongitudinal axis of the surgical access device through the proximal endof the elongated channel, the elongated light-emitting shaft including alight transmitting element for emitting light to illuminate the port ofthe access device, wherein a position of the elongated light-emittingshaft is slidably adjustable along the length of the elongated channel.2. The access system of claim 1, wherein the elongated channel includesa window to the interior path to transmit light produced by the lighttransmitting element to the interior path.
 3. The access system of claim2, wherein the window is elongated.
 4. The access system of claim 1,wherein the light transmitting element comprises a fiber optic strand.5. The access system of claim 1, wherein the elongated channel andlight-emitting shaft have a wedge-shaped cross-section.
 6. The accesssystem of claim 1, wherein the light transmitting element is connectedto a light source for producing light.
 7. The access system of claim 1,further comprising a retaining means for retaining the light-emittingshaft within the elongated channel.
 8. The access system of claim 1,wherein the light-emitting shaft is mounted on a base.
 9. The accesssystem of claim 8, wherein the base includes a plurality oflight-emitting shafts protruding therefrom, each light-emitting shaftconfigured to be inserted in a corresponding elongated channel on thesurgical access device.
 10. The access system of claim 1, wherein theelongated channel comprises gap formed in the side wall of the surgicalaccess device, and the light-emitting shaft is received in the gap toenclose the interior path.
 11. An illuminated surgical access system forproviding access to a patient during surgery, comprising: a surgicalaccess device comprising at least one sidewall, defining an interiorpath forming a port for accessing the patient and an elongated channelformed in the side wall on an exterior surface of the surgical accessdevice, the elongated channel extending from a proximal end of theelongated channel to a distal end of the elongated channel; and astraight elongated rigid light-emitting shaft slidably inserted in theelongated channel along a longitudinal axis of the surgical accessdevice through the proximal end of the elongated channel, the elongatedlight-emitting shaft including a plurality of outlets for a plurality oflight transmitting elements along the length of shaft for emitting lightalong the length of the light-emitting shaft to illuminate the port ofthe access device, wherein a position of the elongated light-emittingshaft is slidably adjustable along the length of the elongated channel.12. The access system of claim 11, wherein the elongated channelincludes a plurality of windows, each configured to align with acorresponding outlet on the light-emitting shaft when the light-emittingshaft is inserted in the elongated channel.
 13. A light emitter for asurgical access system, comprising: an annular base having a centralaxis; a plurality of protruding elongated shafts extending in adirection of the central axis from the base toward a surgical sitethrough a surgical incision, the plurality of protruding elongatedshafts distributed about the perimeter of the annular base, theplurality of protruding elongated shafts being sized to be received in agroove on an exterior side wall of an access device of the surgicalaccess system; and a plurality of fiber optic cables extending from alight source to the annular base, a subset of the fiber optic cablesbranching from the annular base through each protruding elongated shaftand terminating at an outlet provided along the length of the respectiveprotruding elongated shaft so as to emit light from the protrudingelongated shaft, wherein each protruding elongated shaft includes abranched path with a plurality of outlets for emitting light therefrom,the plurality of outlets being provided on the same side of theprotruding elongated shaft.
 14. A light emitter for a surgical accesssystem including an access device, wherein a channel is provided on anexternal side wall of the access device, comprising: a housing in theshape of a straight elongated rigid shaft slidably inserted in thechannel provided on the external side wall of the access device of thesurgical access system; a branched path extending through the housing,the branched path having an inlet and a plurality of outlets; a bundleof fiber optic cables passing through the branched path, wherein thebundle of fiber optic cables branches off into branches, with a subsetof the fiber optic cables passing through a branch of the path andterminating at the outlet to emit light transmitted through the subsetof the fiber optic cables; and a transparent, light-transferring mediumencasing the bundle of fiber optic cables, the encased medium beingshaped to form the elongated shaft with the branched path.
 15. The lightemitter of claim 14, wherein the outlets are distributed along thelength of the elongated shaft.
 16. The light emitter of claim 14,wherein the housing has a wedge-shaped cross-section.
 17. The lightemitter of claim 14, further comprising retention means for retainingthe housing in a corresponding channel of the access device.
 18. Thelight emitter of claim 17, wherein the retention means comprisesflexible fingers on an outer surface of the housing for releasablyengaging recesses in the corresponding channel.
 19. A tubular surgicalaccess system, comprising: a tubular surgical access device including: atubular body having a side wall and defining a path therethrough forminga port for accessing the patient; an elongated channel formed on theexterior side wall of the tubular body, the elongated channel extendingfrom a proximal end of the elongated channel to a distal end of theelongated channel; and a plurality of windows formed in the elongatedchannel along the length of the elongated channel for interfacing theelongated channel with the path through the tubular body; and a straightelongated rigid light-emitting shaft slidably inserted in the elongatedchannel along a longitudinal axis of the surgical access device throughthe proximal end of the elongated channel, wherein a position of theelongated light-emitting shaft is slidably adjustable along the lengthof the elongated channel.
 20. The surgical access system of claim 19,wherein the window is elongated.
 21. The surgical access system of claim19, wherein the elongated channel is formed on an outer surface of theside wall.
 22. The surgical access system of claim 19, wherein theelongated channel extends longitudinally within the side wall of thetubular body.
 23. The surgical access system of claim 19, wherein theelongated channel extends substantially parallel to the path.
 24. Amethod of accessing a surgical site in a patient comprising the stepsof: providing a surgical access device comprising at least one sidewallhaving an elongated channel formed on an exterior surface of thesurgical access device and defining a path therethrough forming a portfor accessing the patient, the elongated channel extending from aproximal end of the elongated channel to a distal end of the elongatedchannel; inserting a straight elongated light-emitting shaft into theelongated channel along a longitudinal axis of the surgical accessdevice through the proximal end of the elongated channel; and adjustinga location of the elongated light-emitting shaft in the elongatedchannel by sliding the elongated light-emitting shaft along theelongated channel.
 25. The method of claim 24, further comprising thestep of emitting light from the elongated light-emitting shaft.
 26. Themethod of claim 25, further comprising the step of directing the lightthrough the port towards the surgical site.
 27. The method of claim 25,wherein the step of emitting light comprises powering a light sourceconnected to the light-emitting shaft to produce light that istransmitted to and emitted from the light-emitting shaft.